Pubdate: Wed, 23 Mar 2016
Source: New York Times (NY)
Copyright: 2016 The New York Times Company
Contact: http://www.nytimes.com/ref/membercenter/help/lettertoeditor.html
Website: http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Lisa W. Foderaro
TOWN'S ANTI-DRUG PLAN: SAFE SITE TO USE HEROIN
ITHACA, N.Y. - Even Svante L. Myrick, the mayor of this city, thought
the proposal sounded a little crazy, though it was put forth by a
committee he had appointed. The plan called for establishing a site
where people could legally shoot heroin - something that does not
exist anywhere in the United States.
"Heroin is bad, and injecting heroin is bad, so how could supervised
heroin injection be a good thing?" Mr. Myrick, a Democrat, said.
But he also knew he had to do something drastic to confront the
scourge of heroin in his city in central New York. So he was willing
to take a chance and embrace the radical notion, knowing well that it
would provoke a backlash.
And it has.
Ever since Mr. Myrick, 29, unveiled a plan last month for what he
called a "supervised injection facility," critics have pounced on it
as a harebrained idea that would just enable more drug abuse. A
Republican state legislator, Tom O'Mara, called it "preposterous" and
"asinine," and a Cornell law professor, William A. Jacobson, said it
would be a "government-run heroin shooting gallery."
But others, including workers on the front lines of the heroin
epidemic and some law enforcement officials, view the proposal as an
important tool in the battle against addiction and overdoses, a way
to keep users alive long enough to connect them to treatment. In the
plan, users would be under medical supervision and could inject only
a small amount of heroin.
The plan would need state approval, and it faces a steep climb in the
arena of public opinion. But the unorthodox idea has drawn attention
at a time of intense concern about the growing toll of heroin abuse,
which, along with prescription opioid painkillers, kills 78 people a
day, according to the federal Centers for Disease Control and
Prevention. Many of them are overdosing not in squalid rooms but in
public places.
Since announcing the plan on Feb. 24, Mr. Myrick has taken pains to
explain to the public that a supervised injection center is only one
pillar of a four-part plan that also addresses prevention, treatment
and law enforcement.
Mr. Myrick said his father battled crack cocaine addiction, which
helped inspire him to create the committee to confront the heroin problem.
Though unheard-of in the United States, supervised injection sites
have existed in Europe for years - one of the first was in
Switzerland, 30 years ago - and in Vancouver, British Columbia, the
only city in North America where the practice is allowed. They have
been linked to a reduction in harm from heroin abuse: In Vancouver,
fatal overdoses dropped 35 percent in the community surrounding its
main injection site in the two years after it opened in 2003 and fell
9 percent citywide.
Here in Ithaca, a city of 30,000 in the Finger Lakes region, there
were more than a dozen heroin overdoses, three of them fatal, in a
span of a week and a half in 2014, shortly after Mr. Myrick appointed
the committee that proposed the injection center. The Tompkins County
Health Department does not break out overdoses by municipality, but
in 2014, the most recent year for which data is available, there were
14 fatal overdoses in the county, where Ithaca is the only city.
The proposal for an injection facility, part of "The Ithaca Plan: A
Public Health and Safety Approach to Drugs and Drug Policy," would
require changes to a number of state and federal laws, according to
state health officials.
Gov. Andrew M. Cuomo, a Democrat who has mounted a forceful response
to the heroin epidemic, told reporters at an unrelated news
conference recently that he was unfamiliar with the details of the
Ithaca plan and would not offer his opinion.
Much of the Ithaca drug plan has been embraced by a cross section of
the community. The plan calls for more drug education, both for
children and adults; improved mental health screening; a
detoxification center; and a methadone clinic. But the supervised
injection program has divided local law enforcement officials.
Ithaca's police chief, John R. Barber, said he could not support the
proposal because "right now, heroin is considered an illegal
substance under the law." But Gwen Wilkinson, the district attorney
for Tompkins County who helped lead the committee that formulated the
plan, said after its release that she was "prouder than ever to be an Ithacan."
And Assemblywoman Linda B. Rosenthal, a Democrat who leads the
Committee on Alcoholism and Drug Abuse, has endorsed the proposal for
the injection facility, saying she would work on legislation to allow it.
Mr. Myrick, a 2009 graduate of Cornell who was elected mayor at 24,
said the injection site would address three problem areas, by slowing
the transmission of blood-borne diseases like hepatitis and H.I.V.;
reducing the public nature of heroin addiction, with people
increasingly using the drug in parks and public bathrooms; and
creating "pathways" to treatment.
Addicts would be allowed to carry small amounts of heroin into the
injection center where a nurse would explain treatment options. They
would also have access to general health care, an important
component, Mr. Myrick said, since addicts sometimes forgo medical
treatment because of the all-consuming need for heroin.
"They will have just had their fix, so that won't be their first
priority, and they might say to the doctor there, 'Actually my tooth
has been hurting and I have a puncture wound that has gone bad,'" Mr.
Myrick said. "You can begin to treat the other physical things and
get them prepared for their moment of clarity."
In Vancouver, the injection facility stirred controversy when it was
first proposed as part of a comprehensive drug plan in 2001.
According to Donald MacPherson, director of the Canadian Drug Policy
Coalition, the addicts who have availed themselves of the program are
30 percent more likely to get treatment and other health services
than those who do not.
Mr. MacPherson, who was an informal adviser to the Ithaca committee,
served as Vancouver's drug policy coordinator from 2000 to 2009. The
impetus for the program, he said, was about 1,000 fatal overdoses
that occurred over six years in the 1990s. Medical staff at the
city's two injection sites use both oxygen and the medication Narcan
to reverse an overdose.
"There are lots of people who have gotten much better," he said,
referring to addicts who used the injection facilities. "They've
gotten onto methadone and into housing. It's a place of empowerment."
In Ithaca, Herebeorht Howland-Bolton, a 26-year-old self-described
heroin addict with a shock of auburn hair, said he would welcome a
place to use heroin under the watchful eyes of medical staff. He
started using heroin when he was 14, has been in and out of jail 16
times and through rehab twice. In mid-February, he overdosed on
heroin and wound up in a hospital.
"It's common sense," he said, after visiting a needle exchange
program here. "You give somebody the option to save their life. My
last three roommates have died from overdoses."
Mr. Myrick said he was gratified that the proposal had ignited a
discussion. The idea to devise a citywide drug plan was prompted, in
part, by his own experience. His father was a crack addict when Mr.
Myrick was born, robbing him of a critical role model. His father now
lives in Florida, and while Mr. Myrick has occasionally heard from
him in the past few years - after 15 years of "radio silence" - he
has not set eyes on his father since he was 6.
"I learned at a very young age that this was a disease and that it
was a powerful one," he said. "I'm just glad people are talking about
it. This has been a quiet epidemic for far too long."
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MAP posted-by: Jay Bergstrom